Healthcare & Insurance

It is advisable to choose a physician before you or a family member becomes ill. Some factors to consider in choosing a personal physician are the cost, the office hours, whether you would prefer a male or female physician, how questions are handled outside of office hours or when the physician is away, the possibility of consulting with the physician by phone, and the physician's response time in an emergency. When choosing a pediatrician you should be sure that the physician will visit your newborn in the hospital, that you will be able to call them frequently when the baby first goes home, that you share the same opinions on issues such as breast versus bottle feeding, and medications for babies and children, and whether the doctor prescribes medication at the first sign of illness or wait to see what develops. 

If you have not enrolled in a health insurance plan and do not have a personal physician in the area, you should telephone or visit the Outpatient Department of the nearest hospital for information about the health care services it provides. You should not use the hospital's emergency room for non-emergency care, since emergency rooms handle only serious problems. In addition, being treated in the emergency room is much more costly than being treated in an office visit. 

Since it is important that your personal physician knows about your individual health history, you should feel comfortable discussing any of your needs and/or concerns with them. Be prepared to tell the doctor or nurse practitioner about your medical history, all medications and any other kinds of treatment or remedies you are using. Also be sure to tell your physician about any medication allergies you have. 

If you are concerned about using English to discuss such important medical information, prepare a list of your questions and concerns before you go to your appointment. Bring along someone who can translate for you, or ask if there is a physician or translator who speaks a language you are more comfortable using. If you ever have difficulty understanding your physician, you should feel free to ask them to repeat, talk more slowly, or explain more carefully. 

Physicians expect you to have questions regarding your health, diagnosis, treatment, or medications. This kind of dialogue between a patient and a physician is a common feature of U.S. health care that may be different from what you may be accustomed to at home. Ask your physician to write down any instructions that you should follow, and tell them if you still have questions or need more information. State what information you need, and ask if you should schedule another appointment. Your physician may suggest other resources for answering these questions or meeting other needs. If you have more questions or problems after you leave the clinic, telephone your physician for advice or another appointment. 

Physicians and nurses rarely make home visits in the United States. Usually you must call for an appointment and visit the physician's office. If you are covered by a health plan, it is usually necessary for you to visit one of the health plan's physicians in order to avoid paying extra fees. For example, Harvard students and affiliates enrolled in the Harvard University Student Health Plan must use HUHS facilities in order to avoid having to pay an office fee. 

The U.S. government regulates the sale and distribution of medications in the United States. Many medications such as antibiotics, strong pain relievers, birth control pills, and drugs for respiratory and heart conditions are available only with a written prescription. Prescriptions, written and signed by a certified physician, are given to patients during an appointment or after a phone consult. The medications ordered in a prescription may only be obtained at a pharmacy or drug store. A pharmacist will package your medication and provide written and verbal instructions on how and when it should be used. Your health plan may or may not cover the cost of medications. 

HUHS operates its own pharmacy located in the Smith Campus Center near the main entrance to HUHS. This pharmacy is open to anyone with a Harvard ID, but fills prescriptions written by HUHS physicians only. If you need to fill a prescription when the HUHS pharmacy is closed, take your prescriptions to a local drug store like CVS or Walgreens to be filled. 

If your physician prescribes medications, be sure to get complete information regarding the medication i.e. where to get it, how to take it, potential side effects, and special instructions such as whether it should be taken with food or whether you should avoid alcohol while you are taking it. Ask your physician if you should finish the prescription completely, or use it only until your symptoms disappear. Inquire also if it is available generically, that is, by the name of the chemical formula rather than the brand name, since generic prescriptions are usually less expensive. 

All international students, scholars, and their dependents should be aware that depending how long they remain in the United States, they may become subject to the terms of the Affordable Care Act (ACA).  More information regarding the ACA can be found on the Harvard University Health Services website. 

The ACA requires individuals who do not maintain “minimum essential healthcare coverage” to pay a fine to the Internal Revenue Service (IRS) when they pay their taxes.  This requirement is known as the “individual mandate.”  The Healthcare.gov website states that persons subject to this “individual mandate” can avoid the fine if they enroll in an ACA-compliant plan. 

Whether the ACA and its individual mandate apply to individual cases depends on the tax status of the individual.  The individual could be considered a resident or a non-resident for tax purposes.  

• Nonresident aliens for tax purposes are not subject to the individual mandate.

• Resident aliens for tax purposes are subject to the individual mandate. 

Generally, students are non-residents for the first five calendar years they spend in the U.S. and scholars are non-residents for the first two calendar years.  Once someone becomes a resident for tax purposes, they also become subject to the terms of the ACA and should be sure they are enrolled in a health plan that is ACA compliant.   The Harvard Student Health Insurance Plan meets this requirement. 

For tax filing purposes, those with a valid Harvard ID and PIN can access Sprintax Returns to determine tax residency status.  If you have left the University and no longer have a valid HUID and PIN, please send your full name and a request for a tax software code to internationaloffice@harvard.edu. 

Health insurance in the U.S. is complicated and very different from the medical practices of other countries.  It is your responsibility to understand the benefits that you are entitled to under the plan you select.  Familiarize yourself with basic terminology and understand the policy terms, exclusions, and costs of the insurance plan.  Being informed is the best way to be prepared should you or your family need medical care while in the U.S.   

For your reference, here are some commonly used terms in the U.S. health insurance system to help you understand your insurance benefits: 

• Copay: A specified dollar amount that you will need to pay for a certain covered medical expense.  Most insurance plans will require this type of payment for every doctor’s visit.
• Coinsurance:  The percentage of the total medical bill you are responsible for paying.
• Deductible: The amount of money you must pay, in each case of accident or illness, before the insurance company starts paying.  Some insurance policies have an annual deductible; others will have a deductible per illness or injury.  It is important that you think carefully about how much you can afford before selecting a plan.
• Dental Insurance:  Most insurance policies will not cover dental procedures, so separate dental insurance is usually required for any dental care that you may need to receive in the United States. However, you can pay for dental care from your own personal funds.  Dental procedures in the U.S. are expensive.
• Preexisting Condition: A medical condition determined to have been in existence before the policy went into effect.  Most insurance policies consider pregnancy a preexisting condition.
• Pregnancy & Maternity:  Many insurance policies do not cover pregnancies that occur either before arrival to the U.S. or during J-1 stays in the U.S.
• Premium: The amount you must pay to purchase the insurance coverage.  Age, medical history, duration of insurance, and number of dependents are some factors that will affect how much your premium will ultimately cost.
• Provider Network: Providers (doctors/hospitals) with whom the insurance company has an agreement. Coverage levels are higher at in-network providers. 

The below is a summary of information. Please visit www.hushp.harvard.edu for additional information. 

Required Student Health Insurance 

Massachusetts law requires that students enrolled in an institution of higher learning in Massachusetts participate in a student health insurance program or in a health benefit plan with comparable coverage. All Harvard students are automatically enrolled in the Harvard University Student Health Program (HUSHP) and the cost of the plan is applied to their student bill. 

The Harvard University Student Health Program (HUSHP) 

The Harvard University Student Health Program (HUSHP) is a comprehensive health program comprised of two parts: the Student Health Fee and the Student Health Insurance Plan 

Student Health Fee 

The Student Health Fee is required as part of enrollment at Harvard, and covers most services at Harvard University Health Services (HUHS). For more information, click here. 

Student Health Insurance Plan 

The Student Health Insurance Plan consists of hospital/specialty care coverage administered by Blue Cross Blue Shield, and prescription drug coverage from Express Scripts. 

For more information on benefits and coverage, click here. 

Important Note for Students in J Status 

Both students and their dependents in J status are required by the U.S. Department of State regulations to maintain health insurance coverage that meets certain requirements. As students are automatically enrolled in the student health insurance plan there is no action to be taken. J-1 students with accompanying dependents, however, must take some action to obtain the required health insurance for their dependents (see the section above for more information on health insurance requirements for J visa holders). 

Student Health Insurance Plan Waiver 

International students may be eligible to waive the Student Health Insurance Plan only if they have health insurance plans with American-based carriers that meet the Commonwealth of Massachusetts standards. Foreign-based policies do not meet Massachusetts standards. 

Students are encouraged to review the information on the HUSHP website carefully before making this important decision. All waivers must be completed online each academic year prior to the waiver deadlines (fall term deadline 7/31; spring term deadline 1/31).  Additional waiver information and the online waiver application are available here. 

If you plan to be accompanied to the United States by your spouse and/or children, it is imperative that you also purchase health insurance for them. As students, you are automatically enrolled in the Harvard University Student Health Program (HUSHP). Your dependents are not automatically enrolled and must take steps to enroll in a health plan. If you do not have adequate medical insurance, an unforeseen medical problem could result in catastrophic expenses that might prevent you from completing your education or research at Harvard. If you or your spouse arrives in the United States with a preexisting condition, including pregnancy, it is essential that you plan ahead for your health insurance needs. For example, the cost of a normal birth with no complications in the Boston area could range from $8,000 to $20,000 or greater, depending on the hospital. 

Dependents of students may choose the Harvard University Student Health Program (HUSHP) or a non-Harvard health insurance plan. If they do not enroll in the Harvard plan, they will not have access to the Harvard University Health Services (HUHS). The Harvard plan for families is expensive, but most available insurance plans that are less expensive will not enroll family members without the student also being enrolled.  Information on enrolling your dependents is available on the HUSHP website.

Dental coverage is not included in the Harvard University Student Health Program (HUSHP). 

Optional dental insurance for Harvard students and their qualified dependents is available through the Blue Cross Blue Shield of Massachusetts Dental Blue Plan. As a member of the Student Dental Plan, you are eligible to receive convenient on-campus care through the Harvard University Health Services (HUHS) Dental Service or from any dentist who participates in the BCBSMA Dental Blue network. Information on coverage, cost, and enrollment deadlines is available on the HUSHP website.